Association of CT phenotype with pulmonary function in patients with chronic obstructive pulmonary disease and influencing factors of prognosis

Objective: To determine the correlation between computed tomography (CT) phenotype and pulmonary function in patients with chronic obstructive pulmonary disease (COPD) and to analyze the influencing factors of prognosis. Methods: In this retrospective study, a total of 174 COPD patients admitted to the First Affiliated Hospital of Hebei North University from May 2017 to October 2020 were enrolled and assigned to the M-type group (n = 48), E-type group (n = 56) or A-type group (n = 70) according to their CT features. The CT features and pulmonary function indexes of all the patients and their correlation were analyzed, and the acute exacerbation in one-year follow-up of the patients was recorded. Logistic regression was carried out to analyze the influencing factors for the prognosis of COPD. Results: The A-type group showed significantly better pulmonary function than the E-type group and M-type group (P < 0.05), and the degree of emphysema was negatively correlated with pulmonary function. The A-type group showed a significantly lower one-year acute exacerbation rate than the other two groups (P < 0.05). A relatively longer course of disease, a relatively lower forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio and CT phenotype were correlated with the unfavorable prognosis of patients. Conclusion: According to determination of the pulmonary function of patients with COPD through CT, the degree of emphysema worsens with the progression of the disease. A relatively longer course of disease, a relatively lower FEV1/FVC ratio and CT phenotype are independent risk factors for unfavorable prognosis of COPD patients.